Department of Medicine, The University of Melbourne at St Vincent's Hospital (Melbourne), 41 Victoria Parade, Fitzroy, Victoria, 3065, Australia.
Department of Rheumatology, St Vincent's Hospital (Melbourne), 41 Victoria Parade, Fitzroy, Victoria, 3065, Australia.
Arthritis Res Ther. 2022 May 10;24(1):103. doi: 10.1186/s13075-022-02790-1.
To describe the epidemiology, determinants and survival impact of gastric antral vascular ectasia (GAVE) in systemic sclerosis (SSc).
Consecutive SSc patients prospectively enrolled in the Australian Scleroderma Cohort Study (ASCS) were included. Univariable and multivariable logistic regression were used to determine the associations of GAVE with clinical manifestations and serological parameters. Kaplan-Meier (K-M) survival curves were used to estimate survival.
The prevalence of GAVE in this SSc cohort of 2039 SSc patients was 10.6% (n = 216) over a median follow-up period of 4.3(1.7-8.4) years. SSc patients with a history of GAVE compared with those without a history of GAVE were older at SSc onset [49.5 (40.0-58.2) vs 46.7 (36.0-56.7) years, p = 0.05]; more likely to have diffuse disease subtype (dcSSc) (35.3% vs 24.1%, p < 0.001); be negative for Scl-70, U1RNP and Scl/PM antibody (4.0% vs 16.1%, p < 0.001, 3.5% vs 7.4%, p = 0.041, 0.0% vs 2.0%, p = 0.042; and respectively) and positive for RNAP III antibody (24.9% vs 8.3%, p < 0.001). Those with GAVE had a worse HRQoL (p = 0.002). Independent determinants of GAVE included the presence of RNAP III antibody (OR 3.46, p < 0.001), absence of Scl-70 antibody (OR 0.23, p = 0.001), presence of GIT dysmotility (OR 1.64, p = 0.004), and digital ulcers; pits; or digital amputation (OR 1.59, p = 0.014).
GAVE is an underestimated and underappreciated SSc manifestation of SSc, which occurs with a relatively high frequency. Identifying an at-risk GAVE phenotype, as presented herein, is of practical importance as screening may prove advantageous given GAVE can be easily diagnosed and treated.
描述胃底腺血管扩张症（GAVE）在系统性硬化症（SSc）中的流行病学、决定因素和生存影响。
连续纳入前瞻性纳入澳大利亚硬皮病队列研究（ASCS）中的 SSc 患者。采用单变量和多变量逻辑回归分析 GAVE 与临床表现和血清学参数的相关性。采用 Kaplan-Meier（K-M）生存曲线估计生存率。
在这项 2039 例 SSc 患者的 SSc 队列中，GAVE 的患病率为 10.6%（n=216），中位随访时间为 4.3（1.7-8.4）年。与无 GAVE 病史的 SSc 患者相比，有 GAVE 病史的 SSc 患者 SSc 发病年龄更大[49.5（40.0-58.2）岁比 46.7（36.0-56.7）岁，p=0.05]；更有可能为弥漫性疾病亚型（dcSSc）（35.3%比 24.1%，p<0.001）；Scl-70、U1RNP 和 Scl/PM 抗体阴性（4.0%比 16.1%，p<0.001，3.5%比 7.4%，p=0.041，0.0%比 2.0%，p=0.042），而 RNA 聚合酶 III 抗体阳性（24.9%比 8.3%，p<0.001）。有 GAVE 的患者 HRQoL 更差（p=0.002）。GAVE 的独立决定因素包括 RNA 聚合酶 III 抗体阳性（OR 3.46，p<0.001）、Scl-70 抗体阴性（OR 0.23，p=0.001）、胃动力障碍（OR 1.64，p=0.004）、以及手指溃疡、凹陷或手指截肢（OR 1.59，p=0.014）。
GAVE 是 SSc 中一种被低估和未被充分认识的 SSc 表现，其发生率相对较高。识别出本文所述的高危 GAVE 表型具有实际意义，因为筛查可能具有优势，因为 GAVE 易于诊断和治疗。
